MEDICARE: MRS. AMBERLY DAWN WRIGHT APRN-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F01200248	OK

General Provider Information

NPI Number	:	1356968150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMBERLY DAWN WRIGHT APRN-CNP

Provider Business Mailing Address
First Line	:	4110 S 100TH EAST AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-3628
Country	:	US
Telephone Number	:	918-857-7246
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 S 100TH EAST AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-3628
Country	:	US
Telephone Number	:	918-857-7246
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2020
Last Update Date	:	06/29/2020

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